My mother had EBV. Should I be concerned about CAEBV?

Question

Hello doctor,

I am a 37-year-old female with downward-trending bloodwork and newly diagnosed severe iron-deficient anemia. I was diagnosed with both EBV and rotavirus as an infant and was consistently sick growing up.

From ages 20 to 30, I have dealt with increasing symptoms of weight loss and gain, severe heat intolerance, severe night sweats, and fatigue. Throughout those years, I have been diagnosed with renal colic, depression and anxiety, GERD, slight fatty liver, and swelling.

Most recently, I have had an ultrasound on swollen neck lymph nodes and have begun experiencing rectal bleeding as well as a severe increase in all other symptoms. My mother also has EBV. Do I need to be concerned about CAEBV?

Please help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I can understand your concern.

Your symptoms are definitely significant and deserve careful evaluation, but based on what you have described, chronic active Epstein-Barr virus (EBV) is not the most likely explanation.

CAEBV (chronic active Epstein–Barr virus) is extremely rare and usually presents with persistent high fever, liver and spleen enlargement, very abnormal blood counts, repeated severe infections, and progressive organ dysfunction.

Your history suggests that your severe iron deficiency anemia, your new rectal bleeding, your swollen lymph nodes, and your long-standing fatigue and night sweats need a more direct and urgent workup for causes like gastrointestinal blood loss, inflammatory bowel disease, celiac disease, chronic infections, or, less commonly, a hematologic condition.

The fact that your bloodwork is trending downward and you have had three episodes of rectal bleeding makes it especially important that you get a colonoscopy and full GI (gastrointestinal) evaluation soon. Swollen lymph nodes also need to be reviewed by a hematologist if they persist or grow.

While past EBV infection is very common, it usually does not cause lifelong worsening symptoms like this.

The priority now is to identify the source of your anemia and bleeding, check for inflammatory or autoimmune disease, and rule out any serious but treatable cause.

Investigations to be done: If you have done any laboratory tests, you can share the results. I will look into it and tell you what to do next.

I hope this information will help you.

Kindly follow up if you have any further concerns.

Thank you.